| NPI | 1750765160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 31030) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ 009873) |
| 1223G0001X Dentist, General Practice (Licence: CO 00203062) | |
| 1223G0001X Dentist, General Practice (Licence: CA 102265) | |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2018-12-13 |